primary prevention
home visitation as a tool for the control and reduction of childhood injuries in low-income shack communities. Implementation, evaluation and costing of a multifaceted programme.

Brief historical background
The ISHS has been planning the development and implementation of a home visitation programme (HVP) for injury control and risk factor identification for settlements like Nomzamo, Broadlands Park, Rusthof (Western Cape) and Thembilihle, Eldorado Park (Gauteng). For the time being, the project will run in Nomzamo and Thembilihle only. The development of the HVP is based on identified best practices for HVPs elsewhere. South African publications on HVPs are scarce, and the evaluations of such HVPS even more scarce. There is therefore heavy reliance on international literature. The need for a local HVP basis, developed with context-specific considerations and evaluated comprehensively. The programme will be of great use for future injury prevention interventions. Part of its evaluation is the development and implementation of an indigenous costing matrix, for the calculation of all intervention costs.

The project has not been fully developed yet, but its basic structure and time frame have been set out by the SIDA/NRF funding proposal, which was submitted on 11 May 2001. According to the official proposal, the project will run from 2002 - 2004. Planning and preparation has already begun however. Actual home visitation will take place during 2002/3, with conducting ten planned home visits; one per month over ten months.

A pilot study of the HVP is under way this year (September, October, November 2001). Rather than focusing on outcomes, the pilot study will focus heavily on developing a costing matrix that includes all relevant cost categories, according to the low-income context and the use of community volunteers. A formative evaluation is conducted simultaneously, with the aim of improving the programme design, and ironing out any possible hitches, that may hamper the process of the full implementation during 2002-4.

Consortia:

• Karolinska Institutet (Prof. Lucie Laflamme, Karin Engström, Marie Haselberg, Marjan Vaez) 
• CAPFSA (Nelmarie Du Toit, Noluthando Loleka)
• Parents' Centre (Fouzia Ryklief)